What Is Plantar Fasciitis?
Plantar fasciitis is inflammation, usually due to injury, of the plantar fascia, the ligament between the front of the heel bone and the base of the toes that helps to support the arch. Excess stress absorbed by the foot may irritate or tear the plantar fascia, making this a common disorder among athletes, especially runners. Although plantar fasciitis may take up to a year to heal fully, it is not a serious health risk, and proper rest and stretching techniques may promote faster healing.
What Causes Plantar Fasciitis?
- A tendency for the foot to roll inward (pronation) upon walking.
- Stress on the heel due to repeated hard pounding or quick turns, often from long-distance running, jogging, or basketball.
- Wearing shoes that lack proper heel support or that have thin or stiff soles.
- Age-related loss of resiliency in the ligaments.
- Some forms of arthritis, such as ankylosing spondylitis or Reiter’s syndrome.
- Obesity and overweight
- Having high arches or flat feet.
Symptoms of Plantar Fasciitis?
- Pain with the first few steps you take upon rising from bed; the pain subsides after a few minutes of walking.
- Sharp or burning pain directly under the heel. Pain worsens with running, prolonged walking or other exercise.
- Feet tingling
- Feet throbbing at night
Plantar Fasciitis Prevention
- Wear running shoes with proper cushioning.
- Avoid exercising on nonresilient surfaces such as concrete.
- Avoid going barefooted, since it strains and stresses the plantar fascia.
Diagnosis of Plantar Fasciitis
- Patient history and physical examination.
How to Treat Plantar Fasciitis
- Rest the foot as much as possible, especially during the first week. Avoid running or jogging; instead, substitute exercises that do not put undue stress on the injured ligament, like bicycling or swimming.
- Apply ice to the tender area daily to reduce inflammation. Try rolling the arch of the foot over an empty tennis-ball can that has been filled with water and frozen; it will cool and stretch the affected area.
- Take over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs), which relieve pain and swelling, or acetaminophen, which will relieve pain but won’t reduce inflammation.
- Insert an over-the-counter heel-support cushion into your shoe. Cut a hole in the pad to relieve pressure on the tender area if necessary. Try to avoid walking barefoot because it may put added stress on the plantar ligament.
- Stretch the ligament with the following exercises (each position should be held for 30 seconds, and each exercise repeated six times; the entire series should be performed three times daily if possible):
- Sit on a table with your knees bent. Loop a towel under the ball of the injured foot and pull, flexing the front of your foot upward. Keep your knee bent and try to press your foot against the towel.
- Perform the exercise as above with the leg extended straight out in front of you. Keep the leg straight during the stretch.
- Sit on a chair and cross the ankle of the injured foot over the opposite knee. Slowly push your toes backward with your hand until you feel the stretch in the bottom of the foot.
- Stand facing a wall, about one foot away, with the injured foot about six inches farther back. Put your hands on the wall and gently lean forward, stretching the lower calf of the back leg.
- Stand facing a wall, about two feet away, with the injured foot about six inches farther back. Keep both feet slightly turned out. Put your hands on the wall and gently lean forward, bending the front knee and keeping the back heel on the floor.
- A local injection of a corticosteroid is often helpful. Rarely, surgery may be recommended in chronic cases.
When to Call a Doctor
- Make an appointment with a doctor if pain does not subside within four to six weeks.
- Call a doctor if pain is severe.
Johns Hopkins Symptoms and Remedies: The Complete Home Medical Reference
Simeon Margolis, M.D., Ph.D., Medical Editor
Prepared by the Editors of The Johns Hopkins Medical Letter: Health After 50
Updated by Remedy Health Media